In Euro-American societies, "resilience" and "post-traumatic growth" are commonly used metaphorical terms for positive responses to extreme adversity. However, research on illness narratives has demonstrated that other cultures may have different metaphorical concepts that act as vehicles for shared beliefs about how to overcome extreme adversity or traumatic experiences. The purpose of this article is to identify metaphors used in various cultures to describe positive responses to extreme adversity and to discuss the cultural ontologies and other socio-cultural factors that shape them. Metaphors of this nature were extracted from psychological, anthropological and ethnographic studies and were organized into categories: battle, path, container, balance, weight, object and network metaphors. Findings support the notion that metaphorical expressions related to positive responses to extreme adversity vary widely across cultures. We argue that an understanding of cultural differences in metaphors for mental health-related concepts is crucial to assisting trauma survivors from different cultural backgrounds.